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Acute Effects of Interleukin-1 Blockade Using Anakinra in Patients With Acute Pericarditis
- Source :
- Journal of cardiovascular pharmacology. 76(1)
- Publication Year :
- 2020
-
Abstract
- Interleukin-1 (IL-1) receptor antagonist (anakinra) has been shown to be effective in steroid-dependent recurrent pericarditis resistant to nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine. We sought to evaluate the acute efficacy of anakinra given early in patients with acute pericarditis. We enrolled patients within 24 hours of presentation of a first or recurrent episode of acute pericarditis who were experiencing severe pain (≥6 in 11-point Likert scale), despite treatment with at least one dose of NSAIDs and of colchicine. The primary outcome was pain relief at 24 hours. Subcutaneous anakinra 100 mg was administered in all patients, whereas NSAIDs and colchicine were suspended for 24 hours. Serum levels of interleukin-6 (IL-6) were measured at baseline and 24 hours. Data are reported as median (interquartile range). We treated 5 patients (4 male and 1 female; 38 [31-54] years old). Anakinra significantly reduced pain from 6.0 (6.0-7.5) to 4.0 (2.5-4.0) at 6 hours (P = 0.012 vs. baseline) and to 2.0 (1.5-2.5) at 24 hours (P = 0.0025 vs. baseline). No patients required rescue pain medication. IL-6 levels were also significantly reduced from 95.3 (24.2-155.1) to 23.9 (4.5-71.9) pg/mL at 24 hours (P = 0.037). The reduction in pain intensity paralleled the reduction in IL-6 serum levels (R = +0.966, P = 0.007). No adverse events related to treatment occurred. The administration of anakinra given early in acute pericarditis treatment course rapidly and significantly improved chest pain from acute pericarditis. The improvement is correlated with a reduction in IL-6 levels.
- Subjects :
- 0301 basic medicine
Adult
Male
Chest Pain
Time Factors
Anti-Inflammatory Agents
030204 cardiovascular system & hematology
Chest pain
Proof of Concept Study
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Acute pericarditis
Interquartile range
Recurrence
medicine
Colchicine
Humans
Pericarditis
Adverse effect
Pain Measurement
Pharmacology
Anakinra
business.industry
Interleukin
Middle Aged
medicine.disease
Blockade
Interleukin 1 Receptor Antagonist Protein
030104 developmental biology
Treatment Outcome
chemistry
Anesthesia
Acute Disease
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 15334023
- Volume :
- 76
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of cardiovascular pharmacology
- Accession number :
- edsair.doi.dedup.....787876eb245a0410ee09fb5c527f6721